In post-mastectomy tattoos, women find healing and beauty

BY JACKIE KRUSZEWSKI CONTRIBUTING WRITER

Richmond tattoo artist Amy Black in her studio.
JENNY McQUEEN After the life-altering diagnosis, after the surgeries, after the radiation and chemotherapy, going near another needle is perhaps the last thing a cancer survivor wants. And many older patients grew up before the current tattoo renaissance. “I always thought about, when I get really old and wrinkly, what a tattoo would look like,” says Wanda Jones, who was diagnosed with breast cancer in early 2015. “I just never – it wasn’t something I had much of a desire to do.”

But after her bilateral mastectomy, radiation and breast reconstruction, she realized a tattoo was a final step. “It gives you a feeling of like, it’s all over with,” says Jones, 56. “You’re back to normal again. Everything looks right.”

While some women opt to keep their new shape after cancerous tissue in their breast is removed, the Journal of Clinical Oncology reported in 2014 that a majority of women in the United States now choose reconstructive surgery. In addition to implants, plastic surgeons can sometimes create three-dimensional nipples, using the patient’s own skin. But often that’s where the surgeon’s skills end.

While artist Amy Black is best known for her natural-looking, post-mastectomy nipple tattoos, some of her clients opt for artistic tattoos over their reconstructed breasts or surgical scars.
JENNY McQUEEN More and more, tattoo artists are called upon to give color to the chests of women who’ve fought or are fighting cancer. Natural tinting is inked onto reconstructed nipples. Tattoos that look like three-dimensional nipples go on implants where the skin is smooth. Inked art covers the physical scars of surgery and chemotherapy. And artistic tattoos can create colorful, permanent designs across a woman’s chest. For many survivors, it’s a way to reclaim control over a body that’s gone haywire or been put through torture – one last remedy in an exhausting series.

JENNY McQUEEN For women like Carol Lilly, tattoos helped her move past her body’s trauma. She was skeptical at first, but after getting implants without nipple reconstruction, she says her breasts looked like a “blank wall.” Her mastectomy surgeon sent the pre-operation pictures to guide the tattoo artist.

“She tattooed exactly what I had before,” says Lilly, 52. “The nipple, the areola – you know how they dimple up around – she tattooed everything back on.”

Lilly came to Richmond from West Virginia for the work, and couldn’t believe she’d ever not considered it. “To look at myself, when I look in the mirror now, I don’t think about the past at all, what I’ve been through,” she says.

Without pictures and having gone two years without nipples, Jones left the shape and coloring of her new tattoos up to the artist. “I didn’t feel like I was missing anything before,” says Jones, who lives in Emporia. “But after she did it, I was just, I don’t know how to describe the feeling – excitement and joy.”

Both Lilly and Jones are talking about Amy Black, the 42-year-old tattoo artist based out of Carytown in Richmond – one of the few but growing number of ink masters who specialize in post-mastectomy tattoos.

Black started in 2010, when a local woman cold-called her, hoping to find a female artist who could create nipples. Black’s 10 years as a tattoo artist, combined with her background in fine art oil paintings – with a focus on nudes – at Columbus College of Art & Design made her a perfect match.

“I didn’t know that I’d do any more than that one,” she says. “I was excited to do that one once.”

Seven years and thousands of nipples later, Black is the Richmond region’s most well-known post-mastectomy artist, and clients have crossed international lines for her work. A network within the breast cancer community – oncologists, plastic surgeons, mammogram nurses and the like – knows her and spreads the word.

“I’ve been showing them to everyone who’ll look at them,” says Jones, laughing.

Additionally, some plastic surgery businesses and centers like VCU Health keep their own in-house staff trained in medical and aesthetic tattoos, specifically for post-reconstruction nipple inking.

Like many other women, Rhonda Ambler of Chesterfield had plenty of time to contemplate her nipple-less breasts after reconstruction. Patients must often wait for the scars to heal and radiation to settle before getting a breast tattoo.

In the meantime, Ambler, 52, got two other tattoos to memorialize her cancer journey – one of a toy that made her laugh during rough times, and a sea turtle to symbolize feminine strength.

So when it was time to give her new breasts color, Ambler opted for an artistic tattoo from Black, rather than nipples. “I’ll be honest, I didn’t like my nipples in the first place, so why would I want them painted back on?” she says.

Ambler describes what she got as black scrollwork covering her breasts with colored stars throughout. On the right breast where the cancer was, there’s a large lavender stargazer. Circles around where the nipples would be give an impression of them. It took Black two sessions and five hours to complete.

“To me, the artistic tattoo was so much more beautiful,” Ambler says.

With earlier detection, Black says the age of post-mastectomy women is falling. And more and more clients are interested in the artistic tattoo option – on flat chests or those with reconstructed breasts. Three-dimensional nipples are still the most popular, sometimes to fix or enhance failed nipple reconstruction.

The consultation process is simple, mostly done by email. Some clients come knowing exactly what they want, and others change their mind. Black says she’s had some women come get nipple tattoos, only to return a few years later wanting more artistic tattoos as well.

Nipples only take about an hour. And while all three women report some pain during the procedure, they say Black is very conscious of post-mastectomy clients. She’ll apply a topical pain reliever and work on another area for a while, if it gets bad.

“The [mastectomy and reconstruction] surgery – that recovery is horrible,” says Ambler. “So in comparison the tattoo was nothing.”

According to Black, health insurance coverage of the procedure varies. Lilly says that her husband, a coal miner, got on the phone with someone at their insurance company to convince them to apply the cost to their deductible. “They weren’t going to,” she says. “But he told them, ‘Now listen, if this was you, I’m sure you’d want this.’”

Lilly says at $600 – $300 a breast – she’d have done it regardless.

Black gives her patients a form coded for insurance claims. And for the artistic post-mastectomy tattoos like Ambler’s, she offers a discounted hourly rate. For those who can’t afford it, or need help covering travel or hotel costs in Richmond, Black has started the Pink Ink Fund, to raise that money.

“It was an awful thing to think, that someone wouldn’t have the money to get the art they need to heal,” says Black.

Jones has since gone all in on post-mastectomy tattoos, getting a phoenix over the scar where a chemo line went in near her collarbone, and she’s planning for another one over a pinprick of ink on the side of her breast the doctors made for her radiation treatments. She’s considering a lion, as her zodiac sign is Leo, potentially connected with the phoenix.

“For someone that never wanted any tattoos,” she says, laughing, “I’ll have quite a few.” ¦